Healthcare Provider Details

I. General information

NPI: 1598671299
Provider Name (Legal Business Name): TRYSTIN MARIE MCKENNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 N LEXINGTON AVE
HASTINGS NE
68901-4409
US

IV. Provider business mailing address

747 N LEXINGTON AVE
HASTINGS NE
68901-4409
US

V. Phone/Fax

Practice location:
  • Phone: 402-705-4134
  • Fax:
Mailing address:
  • Phone: 402-705-4134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number168079
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: